Organization
GRANGER MEDICAL SPECIALISTS, LLC
Active
Organization
GRANGER MEDICAL SPECIALISTS, LLC
Active
Parent organization
GRANGER MEDICAL SPECIALISTS, LLC
Other names
Granger Medical Cottonwood Podiatry
Organization subpart
Yes
Provider details
NPI number
Legal business name
GRANGER MEDICAL SPECIALISTS, LLC
Authorized official
MARY JANE PENNINGTON MD (PRESIDENT/CEO)
(801) 965-3600
Entity
Organization
Contact information
Practice address
6322 S 3000 E STE 100, SALT LAKE CITY, UT 84121-6931
(801) 352-5900
Mailing address
7181 S CAMPUS VIEW DR STE 200, WEST JORDAN, UT 84084-4312
(801) 965-3505
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
04/12/2023
Last updated
04/12/2023
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